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AIDS-MOTHER Jul-31-2012 (990 words) With photo. xxxi
Catholics support plan that reduces mother-to-child transmission of HIV
By Paul Jeffrey
Patient Alpha Samuel holds her 6-month-old son Richard as she listens to a presentation at Our Lady of Apostles Hospital in Akwanga, Nigeria, in this Sept. 2, 2010, file photo. The hospital has witnessed the delivery of babies free from the HIV after treating mothers with anti-retroviral drugs. Richard was born without the HIV. (CNS/Nancy Phelan Wiechec)
Catholic News Service
WASHINGTON (CNS) -- Catholic health care workers are offering enthusiastic support to an ambitious global plan to stop the transmission of the virus that causes AIDS from pregnant mothers to their children.
Discussed during the XIX International AIDS Conference July 22-27 in Washington, the plan involves increasing the availability of the drugs that reduce HIV levels in the body so that transmission does not occur. In wealthy countries, the availability of such drugs has lowered transmission rates to virtually zero, but that's not the case in countries most heavily affected by the HIV epidemic.
"We really do have hope that we can stop AIDS in children," said Msgr. Robert J. Vitillo, a special adviser on HIV and AIDS to Caritas Internationalis who sits on the 15-member international steering committee that is supervising the program.
In 2010, 390,000 children were born with HIV and more than 700 children died each day, almost all of them in India and 21 countries of sub-Saharan Africa, according to the United Nations.
As a result, the Joint United Nations Program on HIV/AIDS -- known as UNAIDS -- in 2011 announced a plan to prevent transmission of the disease to children by assuring that pregnant women get the testing, treatment and counseling they need to stop the virus from spreading. With funding from the U.N. and the U.S. government, The Global Plan towards the Elimination of New Infections among Children by 2015 and Keeping their Mothers Alive takes aim at the 22 hardest hit nations.
Msgr. Vitillo said an important key to the program's success is testing women early, so that any who are found to carry the virus can be put on antiretroviral medications. The women then continue the medication through birth and breast-feeding. While initial programs had discontinued women once the child stopped nursing, Msgr. Vitillo said that approach has been largely discarded in favor of keeping the woman on antiretroviral drugs indefinitely.
"We don't want to save the children and then have them lose their mothers," Msgr. Vitillo told Catholic News Service.
Another part of the program involves early testing of children so that if any are infected, they can receive prompt medical treatment.
Msgr. Vitillo said the program faces challenges that bedevil the entire response to HIV.
"To make this work, we have to figure out what obstacles women face, why they cannot access testing or if they do get tested why they may not come back for the results. It's often a problem of stigma and discrimination, and we need to combat that by involving the entire community in the HIV response," he said.
Health planners say the program can succeed only by becoming "male friendly" in order to prevent male partners from discouraging women of getting involved or from continuing treatment. Men have been a focus of voluntary circumcision programs in several African countries since studies revealed that the procedure drops their susceptibility to infection by more than 50 percent.
Msgr. Vitillo said both Catholic Relief Services and the Catholic Medical Mission Board have worked to design programs for women that intentionally reach out to men. "Sometimes direct communication between husband and wife isn't present or effective, so it takes a little encouragement for the men to be convinced that it isn't just women's business," Msgr. Vitillo said during a July 25 news conference.
In some cases, Msgr. Vitillo said, a woman who comes alone might be urged to write a "love letter" to her partner, inviting him to come along on the next visit. In other programs, a woman who shows up with her male partner is seen more quickly.
Catholic participation in the program was detailed in a report by the Catholic HIV/AIDS Network, released during the conference.
According to researcher Becky Johnson, the survey included 40 Catholic programs in the target countries. While 95 percent of the programs were involved in the national AIDS programs within their respective country and thus follow national guidelines for treating the virus, only 17 percent of the programs had been previously involved in planning or implementing the global plan.
Msgr. Vitillo, one of four civil society representatives on the global steering committee, said that while the church's role was well respected both internationally and in local communities, there often was resistance in the middle -- national governments -- where officials, "concerned about losing funding or losing control of the programs, have a mixed record of including civil society in designing their response."
Catholic agencies face several challenges in implementing the program. The survey found a need for resources beyond just what is needed for testing and treatment. Johnson said many of the agencies also need funding to help women travel to testing and treatment. Nutritional support also was identified as a critical need.
Maryknoll Father Richard Bauer, who until this year ran a wide-ranging HIV education and treatment program in Namibia, said that country's experience proves that combining the church's reach with an emphasis on mothers will yield significant results.
"With more than 2,500 Catholic AIDS Action volunteers, every time one of them saw a pregnant woman on the street they would grab her and say, 'Do you know where the clinic is? Do you know there's a medicine that can help your baby be born HIV-negative?' It has become a joke of sorts that if you're pregnant you have to watch out for the AIDS volunteers," Father Bauer said. "But that enthusiasm has made Namibia a success story in combating AIDS."
The priest explained that the church is well-suited to carry out such a program.
"In order to inform women of the choices they can make to have their baby be HIV negative, we need the community's involvement," Father Bauer said. "We especially need the churches, and we need to preach about this on Sunday. This is the work that the church has always done well, and its involvement makes me hopeful it will really happen."
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